PROJECT SUMMARY In the United States, nearly 8 million older adults rely on family and other unpaid caregivers (neighbors; friends) for assistance with their health care. These caregivers collectively provide 75-80% of the total care hours to community-dwelling older persons, and fill multiple gaps in the health care system: attending doctor's visits, coordinating care, and assisting with treatment regimens. The availability and adequacy of assistance provided by family and unpaid caregivers has direct implications for health care costs and quality of care of older adults. Yet, caregivers are not systematically identified in health care delivery systems, and their abilities and needs are not routinely assessed. Primary care practices are well positioned to aid in identifying and addressing the needs of at-risk family caregivers ? in particular, persons who suffer from caregiving-related stress or have unmet needs for training or support ? through systematic screening and referral. The goal of this project is to develop, implement, and pilot test a screening-referral system for family caregivers who accompany older adults to their primary care visits, with explicit consideration of the distinct needs of dementia and non-dementia caregivers. Aim 1 will conduct the first ever nationwide survey of caregiver screening practices among US providers (physicians, nurses, social workers, physician assistants) working in primary care. Aims 2-4 will leverage partnerships with three primary care practices serving diverse patient populations to engage key stakeholders (caregivers, patients, and health care professionals) in developing, refining, and pilot testing the screening-referral protocol. Catherine Riffin, PhD is ideally situated to spearhead this line of research given her academic background in applied gerontology, and productive track-record of research on family relationships and health. Her long-term goal is to lead a program of social scientific research that designs, evaluates and disseminates evidence-based interventions for family caregivers in real-world contexts. To achieve this goal, Dr. Riffin will pursue additional training and mentorship in four key areas during the K01 award period: implementation science, healthcare policy-making, intervention research, and independent grant writing and professional development. Career development activities will consist of formal coursework, applied learning and research opportunities, and ongoing mentorship from leading experts in the fields of family caregiving, health services research, and applied research methods. Dr. Riffin has assembled a strong, multidisciplinary team of mentors and advisors with expertise in family caregiving, clinical trial design, healthcare policy, and implementation science, and with extensive experience in mentoring junior researchers to independence. If funded, this award will provide Dr. Riffin with the intensive training, research experience, and mentorship needed to launch her career as a successful independent investigator.